Share

Medical anthropologist Adia Benton spent two years looking at HIV programs in Sierra Leone. What she saw unsettled her. “It calls into question what international programs like this do to people,” she tells us. Benton is an assistant professor of medical anthropology at Brown University and author of the forthcoming book, HIV Exceptionalism: Development through Disease in Sierra Leone.

HIV support groups in poor nations often urge members to disclose their status. Benton says this was an approach imported, in part, from vocal American AIDS activists of the 1980s. “Silence was equated with death, in the sort of ACT UP activism in the US. And when they gained ground in places outside of the US, those are the components that came with them.”

The public health benefits of disclosure are clear: it reduces stigma and transmission rates and can help HIV positive people feel less alone. Even so, Benton found many people just did not understand why they were expected to speak out. “People are very ambivalent about this because they want to contribute to public health but they also want to protect themselves,” she says. “I heard a lot of people, or leaders, pressuring others to be ‘good activists’. They wanted everybody to be a good activist and they wanted everybody to be a good advocate, and not everyone can do that.”